Variation in the Canadian Provincial and Territorial Responses to COVID-19

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Variation in the Canadian Provincial and Territorial Responses to COVID-19 BSG Working Paper Series Providing access to the latest policy-relevant research Variation in the Canadian provincial and territorial responses to COVID-19 BSG-WP-2021/039 March 2021 Emily Cameron-Blake, Blavatnik School of Government, University of Oxford Charles Breton, Centre of Excellence on the Canadian Federation, IRPP Paisley Sim, Centre of Excellence on the Canadian Federation, IRPP Helen Tatlow, Blavatnik School of Government, University of Oxford Thomas Hale, Blavatnik School of Government, University of Oxford Andrew Wood, Blavatnik School of Government, University of Oxford Jonathan Smith, unaffiliated Julia Sawatsky, unaffiliated Zachary Parsons, unaffiliated Katherine Tyson, unaffiliated Copyright for all BSG Working Papers remains with the authors. Variation in the Canadian provincial and territorial responses to COVID-19 BSG-WP-2021/039 March 2021 Emily Cameron-Blake, Blavatnik School of Government, University of Oxford Charles Breton, Executive Director, Centre of Excellence on the Canadian Federation, IRPP Paisley Sim, Policy Scholar, Centre of Excellence on the Canadian Federation, IRPP Helen Tatlow, Blavatnik School of Government, University of Oxford Thomas Hale, Associate Professor, Blavatnik School of Government, University of Oxford Andrew Wood, Blavatnik School of Government, University of Oxford Jonathan Smith, unaffiliated Julia Sawatsky, unaffiliated Zachary Parsons, unaffiliated Katherine Tyson, unaffiliated This working paper is updated frequently. Check for most recent version here: www.bsg.ox.ac.uk/covidtracker The most up-to-date version of technical documentation will always be found on the project’s GitHub repo: www.github.com/OxCGRT/covid-policy-tracker Abstract Canadian provinces and territories took highly divergent approaches to the COVID-19 pandemic. Using the Oxford COVID-19 Government Response Tracker indicators and aggregate stringency indices, this paper explores variation in the timing and relative stringency of government responses across 13 Canadian provinces and territories. Canada is a decentralized federation where provinces and territories develop policies to fit local epidemiological and political contexts. The authors find that many smaller, less populous provinces and territories created the conditions for greater freedom of movement and ‘normalcy’ as compared to larger provinces. With the creation of regional zones and tiered policy triggers, most regions have adopted reactive policies and restrictions, often too late, and not without unintended confusion. To date, the authors find that the benefits of federalism have been unevenly leveraged, a lack of coordination in planning and communication between the provinces and territories is an area of opportunity for improved future pandemic planning. Recommended citation for this paper: Emily Cameron-Blake, Charles Breton, Paisley Sim, Helen Tatlow, Thomas Hale, Andrew Wood, Jonathan Smith, Julia Sawatsky, Zachary Parsons, Katherine Tyson (2021). “Variation in the Canadian Provincial and Territorial responses to COVID- 19”. Blavatnik School of Government Working Paper. Available: www.bsg.ox.ac.uk/covidtracker Recommended citation for the dataset: Thomas Hale , Noam Angrist , Rafael Goldszmidt, Beatriz Kira, Anna Petherick , Toby Phillips, Samuel Webster, Emily Cameron-Blake , Laura Hallas, Saptarshi Majumdar, and Helen Tatlow (2021). “A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker).” Nature Human Behaviour. https://doi.org/10.1038/s41562-021-01079-8 Acknowledgements: The authors thank the OxCGRT Canada Subnational Contributors for their tremendous, ongoing efforts. We are grateful to the strong support from students, staff, and alumni of the Blavatnik School of Government, colleagues across the University of Oxford, and partners around the world for contributing time and energy to data collection and the broader development of Oxford COVID-19 Government Response Tracker. We welcome further feedback on this project as it evolves. We would also like to thank The University of Toronto team behind the CAN-NPI dataset1 for their initial efforts in collecting the following data. We have incorporated and merged the data from the CAN-NPI2 and integrated it into our systematic coding scheme. OxCGRT contributors to the Canadian sub-national dataset: Adil Sayeed Charles Breton Christopher Yoannou Emily Cameron-Blake Helen Tatlow Henry Annan Jonathan Smith Julia Sawatzky Katherine Tyson Michelle Sharma Miriam Pittalis Paisley Sim Rushay Naik Seung Eun Yi Tina Chim Zachary Parsons 1 http://cmajopen.ca/content/8/3/E545.full 2 https://github.com/jajsmith/COVID19NonPharmaceuticalInterventions 1. Introduction and summary The COVID-19 pandemic has taken an outsized human and social toll on Canada, and has been enormously challenging for all levels of government. Many Canadians confronted the reality of COVID-19 when Prime Minister Justin Trudeau’s wife, Sophie Grégoire-Trudeau, tested positive for the virus on March 12, 2020.3 Beginning March 14, 2020 provinces began to declare public health emergencies and enter a period of lockdown with residents mandated to stay home. The relative severity of the 2020 Spring lockdowns were not that different across the country, but the post-lockdown period has been marked by a panoply of dissimilar policy approaches. This paper provides an overview of the 13 Canadian provinces and territories and the key policy decisions taken to curtail the transmission of COVID-19 and protect public health. This paper additionally looks in detail at policies related to facial coverings in public, stay at home requirements, economic support, and school closures. OxCGRT data is complemented by data from the Institute for Research on Public Policy, a Montreal-based think tank, which captures policies related to facial coverings in schools, restaurants and dining, cultural services, and provincially imposed curfews. The epidemic curve shows a first-wave of cases concentrated between March and May 2020, a slackening during the summer months, and a much more severe second-wave beginning mid-September 2020. Growing cases of the more transmissible B.1.1.7 variant are partially responsible for the long-tail of the second-wave that has yet to flatten in densely populated areas of Ontario and Quebec. At the same time, case numbers have slowed to a crawl, or stopped entirely, in northern territories, the Atlantic provinces, and are declining on the prairies. Starkly different provincial approaches may be attributed to who is at the forefront of public messaging - public health officials or partisan Premiers and members of the executive branch. For many Canadians, the COVID-19 pandemic has been a crash-course on the workings of a highly decentralized federation. Federalism - shared rule between federal and sub-national governments - has distinct advantages, such as coordinated policy implementation and procurement. But it also requires layers of cross-jurisdictional coordination which can heighten complexity and move slowly. Since the beginning, provinces have led the healthcare response while the federal government has led Canada’s economic response. There has been no formally coordinated approach to pandemic preparedness. As provinces shift gears to focus on delivering vaccines, priority has been given to residents of long-term care homes and other institutional settings and at-risk healthcare workers. As of March 2021, Canada has reported just under 900,000 cases of COVID-19, and over 22,300 deaths.4 Tragically, more than 80% of COVID-related deaths have occured in long-term care facilities which house elderly and vulnerable people.5 The virus has also disproportionately hit remote and Indigenous communities, highlighting that access to an adequate, guaranteed standard of healthcare is inaccessible to a large number of Canadians. Canada stands out globally for its zealous over-procurement of vaccines - to date over $1 billion has been invested for enough doses to cover 400% of the population.6 The country has also committed doses to the global COVAX initiative which provides vaccines to the developing world, but has been widely criticized for drawing from COVAX for local use.7 Since vaccinations began on December 13, 2020, the roll-out has been marked by supply delays, poor coordination, provincial leaders foisting blame for delays at the federal government, and big public promises. Prime Minister Trudeau has committed that everyone who wants a vaccine 3 https://www.cbc.ca/news/politics/covid19-trudeau-premiers-coronavirus-1.5495001 4 https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html 5https://centre.irpp.org/research-studies/federalism-as-a-strength-a-path-toward-ending-the-crisis-in-long-term-care/ 6 https://www.budget.gc.ca/fes-eea/2020/themes/fighting-covid-19-lutter-contre-covid-19-en.html 7 https://health-infobase.canada.ca/covid-19/vaccination-coverage/ can get one by the end of September 2021. But with under 4% of the population vaccinated as of March 2021, this timeline may prove to be overly ambitious.8 One year into the pandemic, it is clear that sub-national policy responses and outcomes have been highly divergent and that the benefits of federalism have been unevenly leveraged. At the same time, provinces have learned from one another and introduced innovative policy responses such as the creation of the “Atlantic bubble” and responsive lockdown triggers. This paper accompanies the publication of the continuously updated and publicly
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